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SF 3472

Conference Committee Report - 92nd Legislature (2021 - 2022) Posted on 03/31/2022 03:53pm

KEY: stricken = removed, old language.
underscored = added, new language.
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CONFERENCE COMMITTEE REPORT ON S.F. No. 3472

A bill for an act
relating to state government; extending the operation of the Minnesota premium
security plan; transferring money; appropriating money; amending Minnesota
Statutes 2020, section 62E.23, subdivision 3; Laws 2017, chapter 13, article 1,
section 15, as amended; Laws 2021, First Special Session chapter 7, article 15,
section 3.

March 31, 2022
The Honorable David J. Osmek
President of the Senate

The Honorable Melissa Hortman
Speaker of the House of Representatives

We, the undersigned conferees for S.F. No. 3472 report that we have agreed upon the
items in dispute and recommend as follows:

That the House recede from its amendments and that S.F. No. 3472 be further amended
as follows:

Delete everything after the enacting clause and insert:

"Section 1.

Minnesota Statutes 2020, section 16A.724, subdivision 2, is amended to read:


Subd. 2.

Transfers.

(a) Notwithstanding section 295.581, to the extent available resources
in the health care access fund exceed expenditures in that fund, effective for the biennium
beginning July 1, 2007, the commissioner of management and budget shall transfer the
excess funds from the health care access fund to the general fund on June 30 of each year,
provided that the amount transferred in fiscal year 2016 shall not exceed $48,000,000, the
amount in fiscal year 2017 shall not exceed $122,000,000,new text begin the amount in fiscal year 2024new text end
new text begin shall not exceed $70,215,000, new text endand the amount in any fiscal biennium thereafter shall not
exceed $244,000,000. The purpose of this transfer is to meet the rate increase required under
section 256B.04, subdivision 25.

(b) For fiscal years 2006 to 2011, MinnesotaCare shall be a forecasted program, and, if
necessary, the commissioner shall reduce these transfers from the health care access fund
to the general fund to meet annual MinnesotaCare expenditures or, if necessary, transfer
sufficient funds from the general fund to the health care access fund to meet annual
MinnesotaCare expenditures.

Sec. 2.

Minnesota Statutes 2020, section 62E.23, subdivision 3, is amended to read:


Subd. 3.

Operation.

(a) The board shall propose to the commissioner the payment
parameters for the next benefit year by January 15 of the year before the applicable benefit
year. The commissioner shall approve or reject the payment parameters no later than 14
days following the board's proposal. If the commissioner fails to approve or reject the
payment parameters within 14 days following the board's proposal, the proposed payment
parameters are final and effective.

(b) If the amount in the premium security plan account in section 62E.25, subdivision
1, is not anticipated to be adequate to fully fund the approved payment parameters as of
July 1 of the year before the applicable benefit year, the board, in consultation with the
commissioner and the commissioner of management and budget, shall propose payment
parameters within the available appropriations. The commissioner must permit an eligible
health carrier to revise an applicable rate filing based on the final payment parameters for
the next benefit year.

(c) Notwithstanding paragraph (a), the payment parameters for benefit deleted text beginyear 2020deleted text endnew text begin years
2023 through 2027
new text end are:

(1) an attachment point of $50,000;

(2) a coinsurance rate of 80 percent; and

(3) a reinsurance cap of $250,000.

Sec. 3.

new text begin[62Q.521] POSTNATAL CARE.
new text end

new text begin (a) For purposes of this section, "comprehensive postnatal visit" means a visit with a
health care provider that includes a full assessment of the mother's and infant's physical,
social, and psychological well-being, including but not limited to: mood and emotional
well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and
fatigue; physical recovery from birth; chronic disease management; and health maintenance.
new text end

new text begin (b) A health plan must provide coverage for the following:
new text end

new text begin (1) a comprehensive postnatal visit with a health care provider not more than three weeks
from the date of delivery;
new text end

new text begin (2) any postnatal visits recommended by a health care provider between three and 11
weeks from the date of delivery; and
new text end

new text begin (3) a comprehensive postnatal visit with a health care provider 12 weeks from the date
of delivery.
new text end

new text begin (c) The requirements of this section are separate from and cannot be met by a visit made
pursuant to section 62A.0411.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023, and applies to health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 4.

Minnesota Statutes 2020, section 62Q.81, is amended by adding a subdivision to
read:


new text begin Subd. 6.new text end

new text beginPrescription drug benefits.new text end

new text begin(a) A health plan company that offers individual
health plans must ensure that, in each geographic area the health plan company services,
no fewer than one silver plan and one gold plan the health plan company offers apply a
predeductible, flat-dollar amount co-payment structure to the entire drug benefit, including
all tiers.
new text end

new text begin (b) A health plan company that offers small group health plans must ensure that, in each
geographic area the health plan company services, no fewer than one silver plan and one
gold plan the health plan company offers apply a predeductible, flat-dollar amount
co-payment structure to the entire drug benefit, including all tiers.
new text end

new text begin (c) The highest allowable co-payment for the highest cost drug tier for health plans
offered pursuant to this subdivision must be no greater than 1/12 of the plan's out-of-pocket
maximum for an individual.
new text end

new text begin (d) The flat-dollar amount co-payment tier structure for prescription drugs under this
subdivision must be graduated and proportionate.
new text end

new text begin (e) All individual and small group health plans offered pursuant to this subdivision must
be:
new text end

new text begin (1) clearly and appropriately named to aid the purchaser in the selection process;
new text end

new text begin (2) marketed in the same manner as other health plans offered by the health plan company;
and
new text end

new text begin (3) offered for purchase to any individual or small group.
new text end

new text begin (f) This subdivision does not apply to catastrophic plans, grandfathered plans, large
group health plans, health savings accounts, qualified high deductible health benefit plans,
limited health benefit plans, or short-term limited-duration health insurance policies.
new text end

new text begin (g) A health plan company or a pharmacy benefit manager, as defined in section 62W.02,
subdivision 15, must not delay or divide payment to a pharmacy or pharmacy provider, as
defined in section 62W.02, subdivision 14, because of the co-payment structure of a health
plan offered pursuant to this subdivision.
new text end

new text begin (h) Health plan companies must meet the requirements in this subdivision separately for
plans offered through MNsure under chapter 62V and plans offered outside of MNsure.
new text end

new text begin (i) Notwithstanding section 62A.65, subdivision 2, a health plan company may
discontinue offering a health plan under this subdivision if, three years after the date the
silver or gold health plan is initially offered, the silver or gold health plan has fewer than
75 enrollees enrolled in the plan. A health plan company discontinuing a plan under this
paragraph must only discontinue the silver or gold health plan that has fewer than 75 enrollees
and:
new text end

new text begin (1) provide notice of the plan's discontinuation in writing, in a form prescribed by the
commissioner, to each individual enrolled in the plan at least 90 calendar days before the
date the coverage is discontinued;
new text end

new text begin (2) offer on a guaranteed issue basis to each individual enrolled the option to purchase
an individual health plan currently being offered by the health plan company for individuals
in that geographic rating area. An enrollee who does not select an option must be
automatically enrolled in the individual health plan closest in actuarial value to the enrollee's
current plan; and
new text end

new text begin (3) act uniformly without regard to any health status-related factor of enrolled individuals
or dependents of enrolled individuals who may become eligible for coverage.
new text end

new text begin (j) A health plan company must annually report to the commissioner, as specified by
the commissioner, the total enrollment in silver and gold plans under this subdivision.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2024, and applies to individual
and small group health plans offered, issued, or renewed on or after that date.
new text end

Sec. 5.

Laws 2017, chapter 13, article 1, section 15, as amended by Laws 2017, First
Special Session chapter 6, article 5, section 10, Laws 2019, First Special Session chapter
9, article 8, section 19, and Laws 2021, First Special Session chapter 7, article 15, section
1, is amended to read:


Sec. 15. MINNESOTA PREMIUM SECURITY PLAN FUNDING.

(a) The Minnesota Comprehensive Health Association shall fund the operational and
administrative costs and reinsurance payments of the Minnesota security plan and association
using the following amounts deposited in the premium security plan account in Minnesota
Statutes, section 62E.25, subdivision 1, in the following order:

(1) any federal funding available;

(2) funds deposited under article 1, sections 12 and 13;

(3) any state funds from the health care access fund; and

(4) any state funds from the general fund.

(b) The association shall transfer from the premium security plan account any remaining
state funds not used for the Minnesota premium security plan by June 30, deleted text begin2024deleted text endnew text begin 2029new text end, to the
commissioner of commerce. Any amount transferred to the commissioner of commerce
shall be deposited in the health care access fund in Minnesota Statutes, section 16A.724.

(c) The Minnesota Comprehensive Health Association may not spend more than
$271,000,000 for benefit year 2018 and not more than $271,000,000 for benefit year 2019
for the operational and administrative costs of, and reinsurance payments under, the
Minnesota premium security plan.

Sec. 6.

Laws 2021, First Special Session chapter 7, article 1, section 40, is amended to
read:


Sec. 40. REPEALER.

(a) Minnesota Rules, parts 9505.0275; 9505.1693; 9505.1696, subparts 1, 2, 3, 4, 5, 6,
7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, and 22; 9505.1699; 9505.1701; 9505.1703;
9505.1706; 9505.1712; 9505.1715; 9505.1718; 9505.1724; 9505.1727; 9505.1730;
9505.1733; 9505.1736; 9505.1739; 9505.1742; 9505.1745; and 9505.1748, are repealed.

(b) Minnesota Statutes 2020, section 16A.724, subdivision 2, is repealed effective July
1, deleted text begin2025deleted text endnew text begin 2024new text end.

Sec. 7.

Laws 2021, First Special Session chapter 7, article 15, section 3, is amended to
read:


Sec. 3. PLAN YEAR deleted text begin2022deleted text endnew text begin 2023new text end PROPOSED RATE FILINGS FOR THE
INDIVIDUAL MARKET.

The rate filing deadline for individual health plans, as defined in Minnesota Statutes,
section 62E.21, subdivision 9, to be offered, issued, sold, or renewed on or after January 1,
deleted text begin 2022deleted text endnew text begin 2023, and before January 1, 2024new text end, is new text beginno later than new text endJuly 9, deleted text begin2021deleted text endnew text begin 2022new text end. Eligible health
carriers under Minnesota Statutes, section 62E.21, subdivision 8, filing individual health
plans to be offered, issued, sold, or renewed for benefit deleted text beginyear 2022deleted text endnew text begin years 2023 through 2027new text end
shall include the impact of the Minnesota premium security plan payment parameters in the
proposed individual health plan rates. Notwithstanding Minnesota Statutes, section 60A.08,
subdivision 15
, paragraph (g), the commissioner must provide public access on the
Department of Commerce's website to compiled data of the proposed changes to rates for
individual health plans and small group health plans, as defined in Minnesota Statutes,
section 62K.03, subdivision 12, separated by health plan and geographic rating area, no
later than July 23, deleted text begin2021deleted text endnew text begin 2022new text end.

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective the day following final enactment.
new text end

Sec. 8. new text beginTRANSFER.
new text end

new text begin (a) The commissioner of management and budget must transfer $300,092,000 in fiscal
year 2023 from the general fund to the premium security plan account under Minnesota
Statutes, section 62E.25, subdivision 1. This is a onetime transfer.
new text end

new text begin (b) The commissioner of management and budget must transfer $229,465,000 in fiscal
year 2025 from the general fund to the premium security plan account under Minnesota
Statutes, section 62E.25, subdivision 1. This is a onetime transfer.
new text end

new text begin (c) $13,269,000 in fiscal year 2023 is transferred from the general fund to the MNsure
enterprise fund. This is a onetime transfer.
new text end

Sec. 9. new text beginAPPROPRIATIONS.
new text end

new text begin $53,404,000 in fiscal year 2023 is appropriated from the health care access fund to the
commissioner of human services for the MinnesotaCare program. The base for this
appropriation is $113,503,000 in fiscal year 2024, $120,442,000 in fiscal year 2025, and
$60,221,000 in fiscal year 2026.
new text end

new text begin EFFECTIVE DATE.new text end

new text beginThis section is effective January 1, 2023, but only if the
continuation of the state innovation waiver described in Laws 2021, First Special Session
chapter 7, article 15, section 4, is approved.
new text end"

Delete the title and insert:

"A bill for an act
relating to state government; extending operation of the Minnesota premium
security plan; requiring certain additional coverage under health plans; requiring
a report; appropriating and transferring money; amending Minnesota Statutes 2020,
sections 16A.724, subdivision 2; 62E.23, subdivision 3; 62Q.81, by adding a
subdivision; Laws 2017, chapter 13, article 1, section 15, as amended; Laws 2021,
First Special Session chapter 7, article 1, section 40; article 15, section 3; proposing
coding for new law in Minnesota Statutes, chapter 62Q."

We request the adoption of this report and repassage of the bill.
Senate Conferees:
.
.
.
Gary Dahms
Paul Utke
.
.
Matt Klein
Rich Draheim
.
Gene Dornink
House Conferees:
.
.
.
Zack Stephenson
Tina Liebling
.
.
Jennifer Schultz
Carlie Kotyza-Witthuhn
.
Tim O'Driscoll